Mental health issues can affect anyone and pilots are no exception. Despite efforts to destigmatize mental health issues, barriers to disclosing difficulties and seeking professional help or peer support when needed still exist.

For organisations:

• Embed psychosocial risk management as a guiding framework
• Promote mental health
• Mandate Peer Support Programs (PSPs) according to EPPSI and IFALPA guides
• Establish industry-wide mitigation measures to address financial / loss of income concerns
• Establish structured return-to-duty pathways

For the aeromedical process:

• Replace Stigmatizing Application Questions with trust-based discussions between the applicant and the aeromedical examiner (AME)
• Review and clarify EASA MED.055. (e)
• Develop functional impact-based mental health risk assessment methodologies
• Utilise multidisciplinary evaluation teams for complex cases
• Adopt clear standards for mental health referrals
• Stop triggering mandatory reporting to authorities unless the use of psychotropic medication is prescribed
• Adopt a standardised approach to medical certification regulations across EASA states

For mental health professionals:

• Require health professionals to have aviation-specific expertise
• Expand AME mental health competency

ECA advocates for a modern, transparent and evidence-based approach – one that empowers pilots to seek support without fear of negative consequences and ensures that safety is enhanced through a positive and preventative mental health culture. ECA believes that a pilot’s mental health is an essential component of aviation safety. Support structures must be based on science and built on trust, respect and empathy – not fear. To truly move forward, the regulatory and operational environment must adapt to reflect this understanding.

We call upon EASA, the European Commission, and national regulators to join forces with us, pilot associations, mental health professionals, and peer support networks to implement our vision across Europe.

ECA. October 2025.